Revenue Control Analyst - Patient Financial Services

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Under general supervision, of the Supervisor, Revenue Control, this position is responsible for timely resolution of outpatient credit balance accounts, reconciling and posting of outpatient and insurance payments /denials, research of unidentified payments, process credit card payments and provides support for affiliated departments and enhanced customer satisfaction.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Analyzes credit balance accounts, verifying appropiateness and accuracy of charges, contractual allowances, payments, and adjustments.
• Initiates all activity to resolve credit balances, including debit adjustments, contractual corrections, corrected billings, cash posting corrections, payment clarifications, patient and third-party refunds.
• Processes all correspondence relating to refunds for insurance and patient payments.
• Prepares accurate refund check requests for submission to Accounts Payable, providing thorough descriptions and audit trails.
• Reconciles all refunds from the SMS system to the General Ledger system, including variance identification and resolution.
• Reconciliation and manual posting of insurance and patient payments accurately.
• Contacts patients and insurance companies via telephone or written correspondence to determine appropriateness of payment.
• Verifies daily totals, cash totals, and posts to journal and cash record.
• Prepares daily bank deposits and de1ivers to bank.
• Assumes leadership responsibilities of the receipt operations in the absence of the Supervisor.
• Maintains a log for monthly accounting data sent to Data Processing in adherence with the time schedule established for monthly closing, maintains a log for all reports received from Data Processing.
• Reconciles all cash batches to the cash control log.
• Lockbox reconciliation and distribution
• Researching unidentified payments.
• Verifies reconciliation of posted batches to deposits received.
• Verifies all checks returned from the bank for additional or missing information.
• Processes all checks returned from the bank as non-payable items, i.e. no account, non-sufficient funds, etc.
• Completes and posts all adjustments/payment corrections within established timeframes.
• Completes and posts all adjustments/payment corrections within established timeframes.
• Meets all monthly and year-end fiscal closing deadlines as they relate to the payment posting process.
• May perform other job related duties as requested or required.

EDUCATION:

• Level of knowledge generally obtained through completion of at least 2 years of college.

EXPERIENCE:

• One to two years’ patient account or third-party insurance experience preferred
• One year of accounting or bookkeeping preferred
• A comprehensive understanding of third-party contractual requirements and hospital systems and procedures.
• Ability to operate calculator, photocopier, and fax machine.
• Ability to work under time constraints due to departmental deadlines.
• Attention to detail.
• Ability to adapt to changes in workflow.
• Ability to work as part of a “team.”

WORKING CONDITIONS:

• Works in a normal office environment with little exposure to hazards or unpleasant working conditions.
• Mental stress due to accuracy involved.
• Reports to Revenue Control Supervisor.
• Frequent internal contracts including Patient Accounts staff, Accounts Payable, and General Accounting staff.
• Frequent external contacts include third parties and patients.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.